Boehner admits the anti-ACA talk was a lie.

[oldr_n_wsr]

It was a question not an argument.
Thanks for the answer.

[Bicycle Bill]

Why? This may actually be a golden opportunity for a single-payer demonstration program. The Trump Administration is looking for ways to dump Obamacare and CA is poised to step up and show how it's done. It's an ideal way to get the federal government out of non-Medicare healthcare, which the Republicans should love. Why would you want to hang on to a program the GOP government is deliberately trying to undermine if not destroy altogether? A program that, apart from enrollment success, really isn't all that great?

The two biggest reasons the GOP is trying so hard to get rid of the ACA ("Obamacare") is that
1) it was formulated by Democrats, not Republicans and
2) it bears the name of a BLACK Democrat to boot.
If the GOP had come up with the same program back in 2005 and called it "Bushcare", everything would be hunky-dory.

As for it being a program that "really isn't all that great" ... may I point out to you that a USAF F-35 bears little or no resemblance to the venerable P-51 of the 1940s and 1950s; and about the only similarity between the P-51 and the Wright Brothers Flyer is that they both were able to get off the ground under their own power.  Every great idea has to start somewhere; it then gets improved and improved upon from there.  And throwing the baby out with the bathwater and starting fresh from square one — which is what the Trumpanzees seem bound and determined to do — is not 'improvement'.

-"BB"-

[oldr_n_wsr]

17% of private insurance dollars go to administrative costs, only 2% of Medicare/Medicaid.

There is much debate about both those numbers and how they compare. From what I have read (limited as it is) there are arguments on both sides that the criteria for what is included in admin costs are not consistent across the board.

I do have a hard time believing that anything the gov does has only a 2% admin cost.

[BoSoxGal]

Of course you do, you clearly refuse to believe anything the government does is good.

[rubato]

reducing administrative costs,

Has the gov ever done this?

Single-payer both in the U.S. (Medicare and Medicaid ) and internationally has much lower administrative costs.


yrs,
rubato

[Econoline]

If the GOP had come up with the same program back in 2005 and called it "Bushcare", everything would be hunky-dory.

They did--in Massachusetts, in 2006; they called it "Romneycare"...and it worked. If they hadn't been so focused on utterly destroying Obama's Presidency, they could have taken credit for it and made it work even better.

[oldr_n_wsr]

I believe the gov does some good. Defense, roads, bridges, policing, etc.
I just want it to be as small as possible. Especially the feds.
I do not believe the feds should be cradle to grave insurance agents.

But when I read reports that have the medicare admin costs at 2% but they fail to include collection of moneys (IRS does that) or the enforcment of fraud (the FBI does that) nor do they pay the 4%+ premium tax that private insurers pay, that's when I find it hard to believe.
And I have read reports where they say they do include the IRS and FBI into their operating costs.
And the reports were not Huffington vs Heritage.
So who to believe? How to compare?

And the 2% is versus total payouts. Since medicare is primarily for older people who are going to have a higher payout than the young or even the general population, then 2% versus "old people's higher payout" becomes significant.

[Guinevere]

"Romneycare" (and we never called it that here) worked so well we were just listed as the #1 state in the nation in whatever publication decides to rank such things (US News, this time), and for whatever that is worth. Education, medical care, and insurance were cited as tops reasons for the ranking:

“Its vibrant academic environment, innovative and supportive health care policies and modernizing economy, measure for measure, make this small New England powerhouse with a population of 6.8 million the strongest state of all,” the study reads.

[Big RR]

Since medicare is primarily for older people who are going to have a higher payout than the young or even the general population, then 2% versus "old people's higher payout" becomes significant.

Does it? My guess is older people see the doctor far more times than their younger counterparts and have far more claims. It would make sense that processing more claims would cost more, due to the the increased number of claims, and the percentages should roughly be the same. That they are not demonstrates the efficiency.

As for collection costs and taxes, are they included in administrative costs of private insurers. And as for the FBI, private insurance fraud is often investigated by the police and FBI, and like private insurers, Medicare has its own fraud and collections investigators as well.

[Long Run]

Since medicare is primarily for older people who are going to have a higher payout than the young or even the general population, then 2% versus "old people's higher payout" becomes significant.

Does it? My guess is older people see the doctor far more times than their younger counterparts and have far more claims. It would make sense that processing more claims would cost more, due to the the increased number of claims, and the percentages should roughly be the same. That they are not demonstrates the efficiency.

Oldr's inference is correct. The older the population, the more costly the medical conditions. As we have heard repeatedly, the lion's share of medical costs are incurred at the end of life (about 1/4 of all Medicare costs are incurred in the last year of life). Thus, not only do younger people have much fewer medical visits on average, the cost of their visits is far less, compared to the older populations.

Given this demographic difference, the real comparison should be on how much it costs to administer each person covered by private insurance versus Medicare (i.e., a per person annual administrative cost comparison). The articles I have read indicate that Medicare is slightly more costly, and I am sure there are other studies that find Medicare is a bit more efficient, but the bottom line is that when you use an actual cost per beneficiary comparison, the admin costs are in the same ball park. From there you can look to see what other things are included in one number or the other, but the big disparity has already been eliminated and shows that as one would surmise, the government is not multiples more efficient than private business.

[oldr_n_wsr]

As for collection costs and taxes, are they included in administrative costs of private insurers

Yes they are. The one thing I did see across the articles/papers I saw written was that anything other than payouts (to docor, reimbursement to patient, etc) was considered "admin costs".

Also not included in medicare admin costs (in some articles/papers) was housing/building (rent/buy/property taxes/etc) which is included in private insurers admin costs.

[Scooter]

Who says they aren't? I worked in government for years, and even in government owned buildings there was imputed rent for space used charged against the budgets of every ministry.

[rubato]

The admission that they were lying all along becomes even more stark.



http://www.motherjones.com/kevin-drum/2 ... -care-plan

WSJ: Republicans Give Up, Admit They Can't Create a Non-Appalling Health Care Plan

Kevin DrumFeb. 27, 2017 11:14 AM

Our story so far: Republicans spent years vilifying Obamacare and promising to repeal and replace it at their first opportunity. Then that opportunity came, but they still couldn't agree on the "replace" part, so they suggested something called repeal-and-delay: repeal Obamacare now, and work on a replacement plan later. But that turned out to be pretty unpopular even among Republicans, who naturally wanted to know what they were going to get before Obamacare was dismantled. So Republican leaders went back to the drawing board and tried to draw up a replacement plan. So far this has been a dismal failure, for the obvious reason that even a mediocre replacement plan will cost a lot of money, and they don't want to spend a lot of money.

What to do? The Wall Street Journal reports that repeal-and-delay is back:

Republican leaders are betting that the only way for Congress to repeal the Affordable Care Act is to set a bill in motion and gamble that fellow GOP lawmakers won’t dare to block it.

Party leaders are poised to act on the strategy as early as this week, after it has become obvious they can’t craft a proposal that will carry an easy majority in either chamber. Lawmakers return to Washington Monday after a week of raucous town halls in their districts that amplified pressure on Republicans to forge ahead with their health-care plans.

Republican leaders pursuing the “now or never” approach see it as their best chance to break through irreconcilable demands by Republican centrists and conservatives over issues ranging from tax credits to the future of Medicaid.

There you have it. It has "become obvious" they can't craft a decent replacement plan now, so instead they're going to try to convince everyone that they can craft a replacement plan later. This is obvious nonsense, but they're just going to bull ahead and dare anyone to stop them.

This is extremely high-risk-high-reward. First of all, they might just lose. All it takes is three defections in the Senate. Second, they can't repeal everything, and a partial repeal will send the individual insurance market into chaos. Third, President Trump has already gone on record opposing this strategy, and he's not a guy who likes to publicly back down. And fourth, they're leaving themselves open for the mother of all Democratic attacks. I don't think Democrats are nearly as divided as the press would have us believe, but if Republicans go ahead with this plan it will unite the party instantly. Politically, it would be a godsend for Democrats.

The desperation Republicans are showing here is remarkable. They are all but admitting that they flatly can't pass a health care plan that's worth the paper it's printed on. This is not an auspicious start to their plan to show the country how great things can be if they'd just put the GOP in charge once and for all.

If they do manage to repeal it they face the fact that most of the US will see that they hate everyone but the top 2% and will kill people to get bigger tax breaks for the rich.

yrs,
rubato